The nurse is caring for a patient who professes to being an agnostic. Which information should the nurse consider when planning care for this patient’s belief system?

Choice A reason: Acute stress disorder occurs within one month of trauma, with symptoms like nightmares and dissociation. However, symptoms persisting beyond one month, as in this case, indicate PTSD. The patient’s presentation aligns with chronic trauma effects, making PTSD the more likely diagnosis over acute stress disorder.

Choice B reason: General adaptation syndrome describes the body’s physiological response to stress (alarm, resistance, exhaustion). It is not a psychiatric diagnosis and does not account for trauma-specific symptoms like nightmares or emotional numbing. This is unrelated to the patient’s psychological response, making it incorrect.

Choice C reason: PTSD is characterized by persistent symptoms beyond one month post-trauma, including nightmares, intrusive memories, avoidance, and emotional numbing, matching the patient’s presentation. Sexual assault is a common trigger, and the nurse would expect this diagnosis documented due to the chronicity and specificity of symptoms.

Choice D reason: Alarm reaction is the initial phase of general adaptation syndrome, involving acute stress response like fight-or-flight. It is not a diagnosis and does not explain chronic psychological symptoms like recurrent memories or emotional detachment, making it irrelevant to the patient’s trauma-related condition.

Choice A reason: Reorganization, per Bowlby’s Attachment Theory, involves adapting to loss and forming new routines, occurring later in grief. The family’s acute crying and despair reflect disorganization. Assuming reorganization misidentifies the grief stage, risking inappropriate support and neglecting immediate emotional needs critical for processing acute loss in the emergency setting.

Choice B reason: Disorganization and despair, the third phase of Attachment Theory, involves intense emotional distress like crying and screaming after loss, as seen here. The family’s reaction reflects grappling with the reality of death. Recognizing this guides empathetic support, ensuring emotional care aligns with their acute grief, critical for initial coping.

Choice C reason: Yearning and searching involve seeking the deceased or denying the loss, not overt despair like crying and screaming. The family’s reaction aligns with disorganization. Assuming yearning misguides support, potentially overlooking the need for immediate emotional presence, critical for addressing acute grief reactions in the emergency department setting.

Choice D reason: Numbing, the first grief phase, involves shock and disbelief, not active despair like screaming. The family’s emotional outburst indicates disorganization. Assuming numbing risks misinterpreting their grief, delaying empathetic interventions like active listening, essential for supporting families experiencing acute loss and distress in the emergency context.